Integrated reputed company Case Manager/Registered reputed company/RN for Chronic/reputed company Condition in Norfolk, VA!

reputed company Plans is hiring an Integrated reputed company Case Manager/Registered reputed company/RN for Chronic/reputed company Condition in Norfolk, VA and the surrounding areas! This is a full-time, work-from-home position that requires travel to conduct face-to-face home reputed company (reputed company of at least 12 monthly) for chronic/reputed company condition members (asthma, diabetes, heart failure, cancer, heart disease, COPD) in Hampton, Newport News, Yorktown, Williamsburg, VA, and the surrounding areas! Status: Full-time, permanent position (40 hours) reputed company working hours: reputed company to 5pm EST, M-F Location: Applicants must reputed company in Norfolk, VA and the surrounding areas! reputed company responsibilities include: • Responsible for case management services reputed company the reputed company of licensure; develops, monitors, evaluates, and revises the member's reputed company to meet the member's needs, with the goal of optimizing member health care across the care continuum • Performs telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical and behavioral health, reputed company services and long-term services • Identifies members for high-risk complications and coordinates care in conjunction with the member and health care team • Manages chronic illnesses, co-morbidities, and/or disabilities ensuring cost effective and efficient utilization of health benefits; conducts gap in care management for reputed company programs • Assists with the implementation of member care plans by facilitating authorizations/referrals reputed company benefits structure or extra-contractual arrangements, as permissible • Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on care management treatment plans • Presents cases at case conferences for multidisciplinary reputed company. Ensures compliance with regulatory, accrediting and company policies and procedures • May assist in problem solving with provider, claims or service issues. reputed company Member Population Includes: • High Emergency Room (ER) utilizers • Recent hospital discharges • Members diagnosed with chronic/reputed company conditions (Asthma, diabetes, heart failure, cancer, heart disease, COPD) Education: • Associate or Bachelors Degree in Nursing REQUIRED Certification/Licensure: • Registered reputed company (RN) License (Compact or Virginia) REQUIRED Experience: • 3 years experience in Nursing REQUIRED • Case Management experience highly preferred • Managed Care or Health Plan experience preferred • Experience working with chronic/reputed company condition members (Asthma, diabetes, heart failure, cancer, heart disease, COPD) preferred • Experience in home health experience, inpatient case management, hospice, transition of care, and discharge planning preferred • Strong knowledge of physical, psychological, socio-cultural, and cognitive patient needs. • Excellent communication skills, both oral and written, as reputed company as strong problem-solving and analytical reputed company Plans provides health plan coverage to reputed company to one reputed company members in Virginia. We offer a full suite of reputed company products including employee-owned and employer-sponsored plans, as reputed company as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and reputed company enrollees. Our reputed company provider network features a robust provider network, including specialists, reputed company care physicians and hospitals. We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services—reputed company to help our members improve their health. Our reputed company is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and reputed company. Be a part of an excellent reputed company organization that cares about our People, reputed company, Patient Safety, Service, and reputed company. Join reputed company that has a mission to reputed company every day and a reputed company to be the reputed company reputed company of the communities that we serve! To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-103807 Talroo – Health Plan Managed Care, MCO, Health Plan, reputed company, Health Insurance, Nursing, RN, Registered reputed company, reputed company, Chronic, reputed company condition members, Asthma, diabetes, heart failure, cancer, heart disease, COPD, home health experience, inpatient case management, hospice, emergency room, ED, Emergency Department, Discharge Planning, Case Management, Transition of Care, TOC, Norfolk, VA, Remote, Virginia Apply tot his job Apply To this Job